Module 6: Trauma Informed Care

Trauma-informed care is an approach to working with people who have experienced trauma that is rooted in an understanding of the impact of trauma on their lives. Put simply it means making sure that the way you work with your beneficiary is considerate of any past trauma they may have experienced and draws on the following principles:

1. Awareness
2. Safety
3. Trustworthiness
4. Choice
5. Collaboration
6. Empowerment

• An event which leaves a person feeling helpless and terrified because of a lack of control/unpredictability, loss of safety, or fear of serious harm/death
• Defined by the experience of the individual not the event
• Not everyone that experiences trauma will develop chronic symptoms, this will depend on their resilience
• Early childhood trauma has more of an effect than only experiencing trauma as an adult

• Prolonged or multiple trauma (abuse/neglect) usually from caregiver in early childhood • Profound lifelong effects – physical health, mental health and social
• Common among people with mental illness, prison histories, suicide attempts, eating disorders, drug and alcohol addictions
• Likely to continue experiencing trauma into adulthood and throughout life

Physical: Eating and sleeping disorders, pain, low energy, headaches, panic and anxiety
Emotional: Depression, anxiety, vulnerability, panic attacks, fearfulness, anger, irritability, emotional numbness, difficulties in relationships
Behavioural: Self-harm, drug and alcohol abuse, self-destructive behaviours, isolation, suicide attempts
Cognitive: Memory lapses, difficulty making decisions, decreased ability to concentrate, suicidal thoughts
Spiritual: Guilt, shame, self-blame, self-hatred, feeling like a ‘bad’ person, questioning one’s own purpose, feeling damaged

Understanding trauma requires an understanding of attachment theory.

From birth we learn how to relate to others and the world through our caregiver. We are also taught to understand our own emotions and how to control them. Many things are gained through this relationship which are crucial for emotional development and resilience building. If all is well, the child develops a ‘secure’ attachment and is unlikely to have further issues.

1. Secure Attachment

A securely attached child feels confident that should they feel anxious, their care giver will respond. Such security is brought on by interactions which are:

• Sensitive
• Regularly available and reliable
• Warm
• Responsive
• Consistent

The legacy of early attachment is reflected in children’s relationships with others, self-regulation, and emotional openness. Developing secure attachments help them to grow into adults who are more resilient to trauma and who can navigate relationships more easily.

2. Insecure Attachment

If the caregiver is unavailable or abusive an individual may not learn:

• How to feel safe/secure in self and with others
• The difference between intimacy and sexual contact
• To understand facial expressions or how to gage emotions in others
• How to understand and deal with their own emotions
• Confidence, self-worth
• How to engage socially
• How to appropriately get their needs met

These individuals will likely develop an insecure attachment style as an adult. People with insecure attachment styles may think:

• Others cannot be trusted or want to hurt them
• The world is dangerous
• Life is unfair
• Life has no meaning
• They have no control or power
• They need to be on guard all the time
• They are a bad person and the abuse was their fault
• They cannot protect themselves

They are unlikely to feel a sense of safety or control within themselves, with others, and with the world.

Building a therapeutic relationship with your beneficiary

• Friendly, but not friends
• Authentic, honest and fair
• Empathic
• Consistent and stable
• Being clear of your role
• Active listening
• Non-judgemental
• Validate their actual emotions and feelings
• Be aware and honest about what you can/can’t do, know/don’t know
• Strong role model
• Clear boundaries

The main things for you to consider as a volunteer

1. What has happened to the individual not what is wrong with them
2. How can I make my beneficiary feel safe?
3. You are not here to heal or help, you are here to support and empower